Provider Demographics
NPI:1003259896
Name:BURNS, LANDON TYLER (MD)
Entity Type:Individual
Prefix:
First Name:LANDON
Middle Name:TYLER
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 649113
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75264-9113
Mailing Address - Country:US
Mailing Address - Phone:855-343-5763
Mailing Address - Fax:855-343-5763
Practice Address - Street 1:120 STONE CREEK BLVD STE 500
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8210
Practice Address - Country:US
Practice Address - Phone:601-420-2040
Practice Address - Fax:855-343-5763
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MS28313207L00000X
LA309355208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine